Combining professional and lay knowledge to improve patient care

Abstract

Doctors and other health professionals acquire knowledge and skills valuable to society during their training. They are also socialised into adopting professional values and norms of behaviour. Lay people lack that unique socialisation and retain the everyday ethical values and norms of their wider society.1 Although much patient care is judged right and good by both doctors and lay people, disjunctions between professional and lay values and norms can harm and distress patients. Those disjunctions can be hard to bridge. Doctors can find it difficult to notice and accept differences between their values and interests (stakes) and those of lay people, especially those of patients, people in clinical relationships with them. When lay people criticise professional or institutional practice, they usually have to go against the professional (or the managerial) grain; and that requires evidence and careful argument. Here I analyse the sources of knowledge that lay people draw on: general lay knowledge, semi-specialised lay knowledge, and specialised lay knowledge. Each springs from lay people’s feelings of disquiet that tell them that some social values or norms may be being breached and that prompt them to seek knowledge that will confirm or refute their concerns. The sensitivity and skill with which lay people do this varies, as do their opportunities for taking action. But the analysis may help clarify some of the issues and inhibitions that hinder doctors and lay people from working together to improve patient care. Our society holds that humaneness, acting as befits a human person,2 is a fundamental value. In everyday parlance, humaneness means causing …